Which of the following is more likely to get you to drive slower down a street? Or to get the majority of car drivers on that street to slow down?
· A talk with a friend about the dangers of speeding to yourself and others.
· A newly posted sign announcing a lower speed limit.
· A stop sign placed in the middle of the block.
· A series of speed bumps along the road.
Each of these might have an impact. But changing the structure of the road is likely to have the greatest impact on the largest number of people over the longest period of time. And the opposite is also true: a long, smooth, straight-away down a wide road with few intersections or visual distraction invites speed – and most of us instinctively respond no matter what the posted limit. Similarly, the lack of safe sidewalks or bike paths makes us much more likely to use our cars for even short trips. Travel behavior is largely shaped by the transportation environment we inhabit.
So what? Well, to the extent that transportation impacts global warming (it produces about a third of global greenhouse gases), or the livability of our neighborhoods (the transformation of urban villages into isolating suburban sprawl, and perhaps even the pulling apart of today’s multi-generational families, can be partially blamed on the automobile), or the growing diabetes epidemic (significantly caused by obesity which is significantly caused by lack of physical activity)…then how we move around matters.
In the public health world, the environmental equivalents to road structure are the systemic patterns that make some things easy to do – the “default choices” – and others more difficult. Nearly two-thirds of US adults are overweight, and nearly half of that group is obese. But our “obesogenic environment” surrounds us with opportunities to remain physically passive while we eat too much of faux-foods deliberately manufactured to trigger our evolution-based biological craving for fat, salt, and sugar. “Everyone knows that you shouldn’t eat junk food and you should exercise,” says Kelly D. Brownell, the director of the Rudd Center for Food Policy and Obesity at Yale. “But the environment makes it so difficult that few people can do these things.”
And, as we all know, like New Year resolutions, dieting doesn’t work. “If you take a changed person and put them [back into] the same environment, they are going to go back to the old behaviors,” says Dr. Dee W. Edington, the director of the Health Management Research Center at the University of Michigan. “[But] if you change the culture and the environment first, when you get [personal] change it sticks.”
As another health researcher has pointed out, “Personal life-style is socially conditioned. . . . Individuals are unlikely to eat very differently from the rest of their families and social circle. . . . It makes little sense to expect individuals to behave differently than their peers; it is more appropriate to seek a general change in behavioral norms and in the circumstances which facilitate their adoption.”
Unfortunately, neither in transportation nor public health have the full implications of this reality been fully absorbed. During the recent debates over national healthcare some of the fiercest attacks were against the “nanny state” proposal to encourage bicycling or the “anti-free market” idea of influencing the food system. On the other hand, the fact that primary prevention and systemic health promotion were even part of the national debate was (minimally) encouraging. And a new paper by the new Director of the Centers for Disease Control (CDC), Dr. Thomas R. Frieden, might provide the basis for renewed strategic thinking in both fields, although transportation advocates will have to start by translating some of its ideas and language into their own framework and jargon – a task that the following hopefully begins. Continue Reading »
